Provider Demographics
NPI:1962150557
Name:WHITE LILY HEALTH CARE INCORPORATED
Entity type:Organization
Organization Name:WHITE LILY HEALTH CARE INCORPORATED
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:OREZIME
Authorized Official - Middle Name:FLORENCE
Authorized Official - Last Name:JOCKEY
Authorized Official - Suffix:
Authorized Official - Credentials:DIRECTOR
Authorized Official - Phone:404-729-4190
Mailing Address - Street 1:PO BOX 682821
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30068-0048
Mailing Address - Country:US
Mailing Address - Phone:404-729-4190
Mailing Address - Fax:
Practice Address - Street 1:1000 PARKWOOD CIR SE STE 900
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-2140
Practice Address - Country:US
Practice Address - Phone:404-729-4190
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-14
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care